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Conversion of G to GJ tube and GJ tube exchange

  • Gastrojejunal (GJ) tube placement is a minimally invasive, image guided technique in which a special soft feeding catheter is placed through an existing hole in the stomach (gastrostomy) into the small bowel (jejunum).

    How Boston Children's Hospital approaches GJ tube placement

    This procedure is performed by the hospital's interventional radiologists, who have special training in performing minimally invasive, image-guided techniques in infants and children.

    In addition to the interventional radiologist, your child will be treated by a team of anesthesiologists, nurse practitioners, nurses and technologists who specialize in caring for children.

    We perform GJ tube placements in our suite on the second floor of the hospital, which features three procedure rooms equipped with the latest imaging technology, a recovery area for patients who have received sedation or anesthesia and examining rooms for outpatient visits.

    Contact Us
    Children's Hospital Boston
    300 Longwood Avenue 
    Boston MA 02115 

    fax: 617-730-0541

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  • When is this procedure needed?

    This type of feeding may be necessary to avoid aspiration pneumonia in children who, because of neurological impairment, have vulnerable airways. It is also useful to treat severe gastroesophageal reflux, gastric outlet obstruction and small bowel dysmotility. Jejunal feeding is a benign feeding alternative to intravenous feeding.

    How do I prepare my child?

    Explain to your child in simple terms why the test is needed and what will happen. If this is the initial conversion, tell your child that you will be close by. During the subsequent exchanges, one of the parents can stay with the child during the procedure. He may bring a favorite toy or blanket into the procedure room. Explain that he will need to lie still while the tube is placed.

    No specific preparation is required for this procedure.

    What happens during the procedure?

    • Your child is helped onto a table, where he will lie down.
    • Using x-ray images for guidance, the interventional radiologist threads the feeding catheter into your child's stomach and through it, into his small bowel.
    • At the end of the procedure, the radiologist secures the catheter, usually by inserting a small balloon within the stomach.

    How does it work?

    The catheter and the air in the stomach are visible on the x-ray monitor, permitting the radiologist to accurately guide the catheter to the proper location. The injection of a small amount of contrast medium at the end of the procedure allows the radiologist to confirm that the tip of the catheter is in the correct place.

    What happens after the procedure?

    If the procedure is performed as an outpatient, your child can go home directly. Otherwise, your child will return to the floor or the emergency department. The tube is ready for immediate use.

    How will I learn the results?

    The radiologist will discuss the results with you immediately after the procedure.

    Are there risks associated with this procedure?

    When performed by an appropriately trained and experienced interventional radiologist, GJ tube placement is a safe technique. Like any other invasive procedure, certain complications and side effects can occur. The risk of complications is greatest if the gastrostomy has been created recently. The risks will be explained to you in detail and consent obtained if required.

    Depending on the imaging technology used during the procedure, your child may be exposed to ionizing radiation (x-rays). We believe that the benefit to your child's health outweighs the exposure that occurs during the GJ tube placement. Because children are more sensitive to radiation exposure than adults, we have been leaders in adjusting equipment and procedures to deliver the lowest possible dose to young patients.

The future of pediatrics will be forged by thinking differently, breaking paradigms and joining together in a shared vision of tackling the toughest challenges before us.”
- Sandra L. Fenwick, President and CEO